Walaa Ammar-Shehada about her PhD research: ‘’Silent Struggles: Breast Cancer Survival in the Shadows of Adversity: A Mixed Methods Study of the Experiences of Palestinian Women in the Gaza Strip, occupied Palestinian territory’’

Breast cancer is the most prevalent cancer among women in the occupied Palestinian territory, accounting for 33% of all cancer cases. In Gaza, where healthcare access and resources are scarce, the effects of the disease are particularly severe. This dissertation delves into the lived experiences of Palestinian women diagnosed with breast cancer, focusing on both the pre-diagnosis and post-diagnosis stages. It employs a framework of structural discrimination, using data from a cross-sectional self-administrative survey and 40 semi-structured interviews to explore how societal and political factors shape health-seeking behavior and decision-making processes before and during illness, as well as influencing coping mechanisms post-illness.

The research is structured into several empirical chapters. The first quantitative chapter analyzes socio-demographic factors that influence the stage at which the diagnosis occurs. A qualitative chapter then examines how structural factors either encourage or hinder women from seeking care, drawing on the Right to Health framework. Another chapter investigates the different types of support—both social and instrumental—that women receive, and how this influences their ability to cope with the disease post-diagnosis. The final chapter explores the significance of social support and how the absence of it can result in more negative outcomes.

The dissertation emphasizes the collective challenges faced by breast cancer survivors in Gaza, zooming in on their personal experiences. Through an intersectional lens, the research considers how the interplay of gender, social identity, and social, cultural, and political factors shape these experiences.  The findings show that the presence of social-emotional and instrumental support is crucial for women as they navigate the challenges of breast cancer, while its absence can exacerbate their hardships. The dissertation also sheds light on the broader context of structural discrimination and societal inequalities that prevent Palestinian women from accessing essential healthcare services. Racial segregation, national-origin-based discrimination, and geographically biased policies create compounded challenges, especially in Gaza. Blockade, restricted movement, inadequate access to services, and poor social determinants of health—such as extreme poverty and limited access to early detection —create an environment of uncertainty regarding treatment options.

Ammar-Shehada argues that these forms of structural discrimination obstruct the fulfillment of basic rights, including the Right to Health, particularly for underprivileged women. Her work calls for systemic changes and targeted interventions that address these health and social disparities from the patient’s perspective, advocating for equal access to healthcare and support systems for all women, regardless of race or social status.

Supervisor: Prof. dr. Piet Bracke
Co-supervisor: dr. Melissa Ceuterick